Michaelia Cash (WA, Liberal Party, Minister for Employment, Skills, Small and Family Business) Share this | Hansard source

I rise to sum up the debate on the Health Insurance Amendment (Bonded Medical Programs Reform) Bill 2019. This is one of the targeted strategic responses under the Stronger Rural Health Strategy, which responds to the challenge of ensuring primary health care is accessible and available to all Australians, no matter where they live. Under the strategy, a total of $20.2 million was committed to reform the bonded medical programs. The bonded medical programs are a long-term investment in the health workforce by the Australian government. These schemes are designed to address doctor shortages across regional, rural and remote Australia and in areas of workforce shortages. Participants receive a place in a medical course at an Australian university in return for a commitment to work in underserviced areas.

The bill introduces a statutory scheme, known as the Bonded Medical Program, which will come into effect from 1 January 2020. The statutory scheme consolidates the existing bonded medical places and rural bonded medical scholarship schemes under a single legislative framework to progress the government's long-term view to move towards a single bonded medical scheme. The statutory scheme is clearer about the conditions applied under the program and provides greater flexibility for participants to complete their return-of-service obligation. Participants of the statutory scheme continue to have the right of internal review and now will be able to seek review of administrative decisions by the Administrative Appeals Tribunal. From 1 January 2020, new participants will enter the program under the new statutory scheme, and existing participants will be able to opt in. The statutory arrangements will eventually replace the myriad complex contractual arrangements currently in place with individual participants. Statutory provisions will ensure that existing participants and future participants have access to the same suite of options and opportunities going forward. Legislative amendments will enable entrants to opt in to a statutory scheme without the need for individual contracts. It will make it significantly easier for bonded students and doctors to complete their return-of-service obligation by reducing and streamlining administrative requirements and giving more options as to when, where and how it can be completed. The reformed arrangements will provide earlier and stronger links with key professional support agencies for doctors.

These improvements to the program will encourage doctors to stay working in the community where they are undertaking their return-of-service obligation beyond their obligations and ensure there are more fully-qualified Australian trained doctors working in regional, rural and remote Australia and in areas of workforce shortage. More importantly, the reforms will also better target the future bonded workforce to locations of need as demographic and workforce demands change over time. The statutory scheme will enable the collection of data for reporting and effective evaluation of the programs. At this stage, it is too early to evaluate the program's success; however, it is critical that the government, the medical profession and the Australian public have access to robust evaluation of the program outcomes to inform policy decisions into the future.

Without legislative reforms, existing administrative arrangements will remain outdated and contractual provisions will continue to be required and will continue to obstruct the delivery of effective and responsive targeting of the bonded medical workforce into the future. The program will become increasingly outdated, with growing frustration experienced by participants and the key stakeholder groups which support them. It questions the benefit of retaining a program which, due to its administrative arrangements, is unable to maintain currency or prepare for the future needs of participants and workforce distribution.

It is the government's long-term view to rationalise the bonded medical programs to a single bonded medical scheme once all existing schemes have expired. It is envisaged this will occur around 2035, when all participants under the existing schemes have either completed their obligations under the program or have chosen to opt in to the new statutory scheme. The government is committed to implementing progressive and responsive administrative arrangements, which support both current and future-bonded doctors keen to make a substantial contribution to better access of medical services across Australia, and I commend the bill to the Senate.

Question agreed to.

Bill read a second time.